UBC CUSTOMS SERVICES - EXPORT MEMO  
Document Must Be Legible - Please Print Clearly or Type
Attention: Shirley Martin/Jeanette Johnson - Fax # (604) 822-3261

Consignee [Company]:

Address:

Postal/Zip Code:                                        Telephone:  [         ]

Federal ID# or IRS#: [USA Only]

 

Consignor:    UNIVERSITY OF BRITISH COLUMBIA        [Exporter #108161779RM]

Dept./Faculty:

Address:

VANCOUVER, B.C.         Postal Code:

Attention:

Telephone:                                                Fax:

SpeedChart #:

 

Description of Goods to be Exported:

Quantity:                                            Description:

Model #:                                             Serial #:

Cdn. $ Value:                                     Country of Origin:

Quantity:                                            Description:

Model #:                                             Serial #:

Cdn. $ Value:                                     Country of Origin:

Quantity:                                            Description:

Model #:                                             Serial #:

Cdn. $ Value:                                     Country of Origin:

 

Shipment:

Dimensions:                                        # of Cartons:

Weight:                                    [lbs.]            or                                        [kgs.]

Ship Via:             Ground [    ]                Air [    ]                    Ocean [    ]

Shipment is:        Prepaid [    ]        Collect [    ]

Additional Insurance:          Yes [    ]        No [    ]

Carrier Name:

Waybill #:                                            Bill of Lading #:

Return Authorization #:

Reason for Export:

 

For Office Use Only: Freight Charges:  $